Vasectomy by epithelial curettage without suture or cautery: a pilot study in humans

John K. Amory1, John W. Jessen2, Charles Muller3, Richard E. Berger3

1 Department of Medicine, Center for Research in Reproduction and Contraception, University of Washington School of Medicine, Seattle, WA 98195, USA2 Private Practice Dentistry, Seattle, WA 98195, USA3 Department of Urology, University of Washington School of Medicine, Seattle, WA 98195, USA

Correspondence: Prof. John K. Amory,jamory@u.washington.edu

Received 4 November 2009; Revised 25 November 2009; Accepted 25 December 2009; Published online 15 February 2010.

Abstract

Curettage of the epithelium of the vas deferens might be a safe and effective method of male sterilization. We conducted a pilot study of vasectomy by epithelial curettage with a novel microcurette called the Vas-X in 12 normal men requesting elective sterilization. Seminal fluid analysis was obtained monthly after the procedure for 6 months. Pain was assessed by questionnaire. Three months after the procedure, all men attained sperm concentrations of less than 0.2 million sperm per mL, and seven were azoospermic. Post-procedural pain was minimal. Nine men ultimately achieved and maintained azoospermia; however, 4 to 6 months after the procedure, sperm concentrations increased in three of the 12 subjects, necessitating repeat vasectomy. Microscopic examination of the vas deferens from these failures revealed re-canalization. Vasectomy by epithelial curettage can result in effective sterilization; however, 1/4 of the subjects were not effectively sterilized by the procedure due to re-canalization of the vas deferens. Epithelial curettage will require further refinement to determine if it is a viable form of vasectomy.